Correction: A previous version of this story incorrectly stated that Dr. Fareedat Oluyadi is a nurse. Oluyadi is a Family Medicine physician.
The original story also misstated the current operating hours of the Maternal Care Clinic. The MCC is open 7 a.m. Monday until 5 p.m. Friday and is open 24 hours per day during those operating hours. The story has been updated to reflect this information, the News + Record apologizes for these errors.
A coalition of maternal care advocates, midwives and nurses are sounding the alarm about what they’re fearing as the “impending closure” of the Maternity Care Center at UNC Chatham Hospital in Siler City.
The group began to rally around the issue and press for action just prior to Chatham Hospital Board of Trustees meeting last Tuesday, Aug. 16. At the meeting, Eric Wolak, the chief operating officer and chief nursing officer of Chatham Hospital, told the nurses and others who attended last week’s online meeting the MCC is just one nurse resignation away from needing to close its doors.
No decisions about that have been made, but that didn’t stop more than 70 nurses and community members from attending last week’s hospital, which was held via Zoom.
The MCC is currently the only medical facility in Chatham County for people to give birth. Since it opened two years ago, the unit has delivered more than 210 babies, but has been forced to, on occasion, limit its hours of operation because of staffing shortages related to the COVID-19 pandemic.
Currently, the MCC is open from 7 a.m. Monday to 5 p.m. on Friday — during operating hours the center is open 24 hours per day. Wolak said if laboring patients come after hours they will still be cared for until the point of discharge.
The center is operating with a 35% staffing vacancy rate. To combat the vacancies, the MCC has utilized traveling nurses who rotate between hospitals within the UNC Health network, the hospital has also used nurses from outside that network as short-term solutions. Without those nurses, the MCC would have a vacancy rate of close to 44%, according to Wolak.
These operations represent an improvement from where the hospital was a year ago, Wolak said. In November 2021, the MCC was only operating Monday through Thursday. Wolak said the center needs at least two nurses per shift to operate and ensure safety in baby delivery.
UNC Chatham Hospital was recently identified as a Critical Access Hospital — meaning it receives federal funding to ensure it remains open. The CAH designation is designed to reduce the financial vulnerability of rural hospitals and improve access to healthcare by keeping essential services in rural communities.
Recent trends, however, show nationwide closures of labor and delivery units, like the MCC across the country. In North Carolina, eight rural maternity care units have closed since 2017.
The Chatham MCC is especially valuable because of the people it serves. Despite Census numbers showing that Chatham County is 82% white, 88.8% people delivering through the MCC are people of color, according to data from UNC Chatham Hospital.
Current state of flux
Last week’s meeting left more questions than answers for some nurses and doctors at the MCC.
One of those frustrated doctors was Dr. Fareedat Oluyadi, a Family Medicine physician at UNC Chatham Hospital. She wrote a letter to Chatham Hospital President Jeffrey Strickler sharing her concerns this week. The letter was cosigned by more than 60 community members — many of whom were nurses or doctors in maternal care — and shared during the public comment period at the Chatham County health board’s meeting held Monday night.
“It is with deepest fervor that we write in protest of the impending closure of the Maternity Care Center (MCC) at UNC Chatham Hospital,” the letter said. “We are voicing our concern as not only healthcare workers of the maternity care center, but also as representatives of the community we serve and are committed to caring for.”
The MCC doesn’t regularly share updates before the Board of Health, but they were asked to do so because of public concern following last week’s trustees’ meeting.
“The board of health invited them to provide an update given questions that were coming up around the MCC,” Mike Zelek, director of Chatham County Public Health Department, told the News + Record. “They were added to the agenda before the Hospital Board meeting last week. While there haven’t been regularly scheduled updates, there have been presentations to the Board of Health about the MCC in the past, especially as it was coming to fruition.”
Dr. Oluyadi’s letter concluded with a call to action asking the hospital to commit to a moratorium on the decision to close the MCC. Physicians and nurses called for engagement with the community and for the hospital to do everything in its power to keep the center open.
At Monday’s health board meeting, however, Strickler characterized the urgency of the letter as “misinformation,” reiterating that no decision had been made about the MCC’s future.
Strickler also announced the creation of a community task force, which would embark on a 60-day investigation into the long-term viability of the MCC. The task force will consist of 17 members, each from different community health organizations; the members of the task force have not been announced.
While the center will remain open for the time being, Strickler did say staffing shortages are hurting the department. The MCC had three nurses resign in July, which significantly impacts a staff of 11 total nurses who don’t work remotely but must work on-site. He also said since the clinic opened two years ago, turnover has created ongoing staffing shortages — the MCC had a full-time nurse resign or transfer to another department an average of once every other month.
Based on exit interviews conducted by UNC Chatham Hospital, nurses are leaving the MCC for a variety of reasons including taking other travel assignments — positions that typically pay much higher compensation rates — or transferring to different hospitals.
Strickler said exit interview data did not show systemic problems within the hospital that led to MCC nurse resignations.
Nurses and other maternal care employees who have seen the resignations firsthand, however, call the consistent turnover “nothing short of heartbreaking.”
Dr. Oluyadi said she felt unseen, silenced and powerless in a clinic she believed has the necessary resources and power to sustain itself.
“The impending closure of the unit is a hazardous event with rippling adverse outcomes,” Oluyadi’s letter said. “If we do not fight against this passivity — the ideas that things will continue working themselves out — we will fail our community.”
Oluyadi was joined by members of local healthy equity organizations — Equity for Moms and Babies Realized Across Chatham (EMBRACe) and Community Organizing for Racial Equity (CORE). Jean Medearis Costillo, an EMBRACe member, told the Board of Health the MCC is critical to Chatham County because of its rural geography.
“The MCC came about as part of a need identified and supported by many agencies,” Costello said. “And just like other problems, the answer to this problem isn’t always in the hallways of one agency. It sits in the space between our agencies — in the collaborative space.”
Reporter Ben Rappaport can be reached at brappaport@chathamnr.com or on Twitter @b_rappaport.